My internal medicine rotation allowed me to gain valuable experience in managing medically complex patients in both the inpatient and emergency department settings. Throughout this rotation, I developed skills in clinical reasoning, chronic disease management, diagnostic evaluation, and acute patient care. I was able to care for patients with conditions such as heart failure, pulmonary embolism, cirrhosis, acute respiratory failure, infections, and several other conditions, which helped me strengthen my understanding of disease processes and management in internal medicine. This rotation provided significant exposure to patients with multiple comorbidities, reinforcing the importance of comprehensive and detail oriented care.
Something new that I was exposed to during this rotation was the complexity of caring for acutely ill patients with multiple chronic conditions and how quickly their status can change. Unlike previous rotations, getting a thorough and comprehensive history was very important for admitted patients, as knowing their prior hospitalizations would aid the course of management during their current one. Many patients presented with multiple ongoing medical problems, requiring me to prioritize urgent concerns while still considering long term disease management. Initially, I found it challenging and slightly overwhelming to organize such extensive histories and interpret the labs and imaging results and create a focused plan for the patient. However, with guidance from my preceptors, I learned how to synthesize relevant clinical information that addressed both immediate stabilization of the patient and long term outcomes.
Throughout this rotation, I also gained exposure to medication management, such as fluid administration, medication reconciliation, monitoring for complications, and coordinating care with multidisciplinary teams. These experiences reinforced how internal medicine requires broad medical knowledge and several healthcare team members when evaluating and managing complex patients. Another important aspect of this rotation was improving my physical exam skills and patient interactions, particularly in medically complex patients. I also gained experience in observing and participating in several procedures, such as IV placements, ABGs, staple removal and NG tube placement. I participated a lot in documentation, communication with other healthcare teams, and patient education regarding their disease process.
Overall, this rotation was an extremely rewarding experience that significantly strengthened my clinical skills, confidence, and medical knowledge in internal medicine. I believe that my prior rotations have prepared me well for this rotation and as I have concluded my general medicine rotations, I feel more confident in managing patients comprehensively by prioritizing acute concerns while also acknowledging chronic conditions.
